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The rise of cholesterol testing: how much is unnecessary

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1 The rise of cholesterol testing: how much is unnecessary
by Helen Doll, Brian Shine, Jonathan Kay, Tim James, and Paul Glasziou BJGP Volume 61(583):e81-e88 February 1, 2011 ©2011 by British Journal of General Practice

2 Number of total cholesterol tests requested from 1987 to 2007 in Oxfordshire, UK and dates of key guidelines and statin trial publications. Number of total cholesterol tests requested from 1987 to 2007 in Oxfordshire, UK and dates of key guidelines and statin trial publications. QOF = Quality and Outcomes Framework. Helen Doll et al. Br J Gen Pract 2011;61:e81-e88 ©2011 by British Journal of General Practice

3 Number of total cholesterol, triglyceride, and high-density lipoprotein (HDL) cholesterol tests requested per year by primary care (open bar areas) and secondary care (shaded bar areas). Number of total cholesterol, triglyceride, and high-density lipoprotein (HDL) cholesterol tests requested per year by primary care (open bar areas) and secondary care (shaded bar areas). Helen Doll et al. Br J Gen Pract 2011;61:e81-e88 ©2011 by British Journal of General Practice

4 Total number of tests performed per 3-year period, broken down within each bar by frequency of testing (1, 2, 3, 4, 5, ≥6 tests per person: the darker the shading the greater the test frequency). Total number of tests performed per 3-year period, broken down within each bar by frequency of testing (1, 2, 3, 4, 5, ≥6 tests per person: the darker the shading the greater the test frequency). Tests performed on a total of individuals. Helen Doll et al. Br J Gen Pract 2011;61:e81-e88 ©2011 by British Journal of General Practice

5 Mean total serum cholesterol levels, with standard deviation (SD) bars, for individuals with one to six or more tests during each 3-year period. Mean total serum cholesterol levels, with standard deviation (SD) bars, for individuals with one to six or more tests during each 3-year period. Overall mean values are shown for those tested for diagnosis (one or two tests per period; solid line joining circles) and for those tested for monitoring purposes (three or more tests per period; dotted line joining triangles). Helen Doll et al. Br J Gen Pract 2011;61:e81-e88 ©2011 by British Journal of General Practice

6 Mean total serum cholesterol levels at each test for patients with one (circle) to 6 or more tests (subsequent test values joined by a solid line) during each 3-year period. Mean total serum cholesterol levels at each test for patients with one (circle) to 6 or more tests (subsequent test values joined by a solid line) during each 3-year period. The six lines in each graph represent the number of tests during each 3-year period. Helen Doll et al. Br J Gen Pract 2011;61:e81-e88 ©2011 by British Journal of General Practice


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